Knee prosthesis

ABSTRACT

The invention shows a knee prosthesis comprising a medial condyle ( 1 ) and a lateral condyle ( 5 ), the running surfaces ( 2 ) of which and the counter-surfaces A, B of which that lie on a tibia platform ( 3 ) are sections of spherical surfaces with radii R 1 , R 2 , with their center M 1 ′ and M 2 ′ forming in their vertical projection onto the counter-surfaces A, B the points M 1  and M 2 . The lateral counter-surface B belongs to a lateral meniscus part ( 7 ) which, guided on a plane ( 13 ) of the tibia platform, is pivotal with the point M 2  on a circular arc with radius R 3  about the point M 1 , with the radius R 3  corresponding to the distance a of the centers M 1 ′, M 2 ′.

[0001] The invention relates to a knee prosthesis comprising a medial condyle, the running surface of which and the counter-surface A of which that lies on a tibia platform are sections of spherical surfaces with a radius R₁, the center M₁′ of which forms in its vertical projection onto the counter-surface A an axis with a point M₁ about which a lateral condyle is pivotal.

[0002] A knee prosthesis is shown in the patent specification U.S. Pat. No. 5,219,362 in which a large contact surface exists on the medial side between the medial condyle and the oppositely lying tibia platform. In the lateral condyle there is at most a linear contact during the flexion, which leads to undesirably high area pressings.

[0003] The object of the invention is to improve this situation. This is achieved in that the lateral condyle with its running surface and its counter-surface B are likewise sections of spherical surfaces with a radius R₂ with center M₂′, the vertical projection of which onto the counter-surface B corresponds to a point M₂; and in that the counter-surface B belongs to an artificial meniscus part which can be displaced on a plane of the tibia platform and which, guided on a circular arc, is pivotal with the point M₂ about the point M₁ at a distance R₃ which corresponds to the distance a of the centers M₁′, M₂′.

[0004] This arrangement prevents large surface pressings and allows the tibia a rotational movement of the tibia platform about a point M₂ on its medial counter-surface A during the flexion corresponding to the attached ligaments and, with the rotational movement, a movement of the lateral side of the tibia platform towards the anterior, whereas the meniscus part of the lateral side remains in place relative to the lateral condyle.

[0005] Subordinate claims 2 to 11 are advantageous further developments of the invention. Thus the tibia platform is pivotal from a middle position which corresponds to the extension position and in which the points M₁, M₁′, M₂, M₂′ lie in a transversal plane of the tibia platform by an angle α₁≧0 towards the posterior into a position which corresponds to the hyperextension and in the event of complete flexion by an angle α₂ between 5° and 20° towards the anterior. Furthermore, it can be advantageous to limit the sum of the angles α₁ and α₂ to a value between 12° and 18° in order constructionally to achieve a larger counter-surface B for the lateral condyles.

[0006] A circular-arc-shaped bulge of the tibia platform, which projects over a sliding plane for the meniscus part and engages into a groove of the meniscus part for the guiding about the point M₁, has the advantage that no foreign objects can collect and be squashed on the sliding plane or in the groove since they are always brushed off again through the relative movement between the meniscus part and the tibia platform. This presupposes that no larger shoulders, but rather at most end abutments for the movement, project above the sliding plane in the direction of movement.

[0007] The tibia platform itself can however also be provided on the lateral side with a wide circular groove, the limiting radii of which have the common center M₁ on the medial side; and the meniscus part is designed as a part of a circular ring which is guided by the groove.

[0008] Through the spherical contact surface on the medial side and through the spherical contact surface of the lateral meniscus part, which is planar on the lower side, the surface pressing can be lowered to such an extent that a plastic body is inserted medially on the tibia platform and that a plastic body is inserted as meniscus part, both for example of high molecular polyethylene.

[0009] The use of plastic bodies medially and laterally has the advantage that the tibia platform can be made symmetrical with respect to its sagittal plane and that the tibia platform can be inserted selectively for a left or right knee in that the medial plastic body can be firmly anchored and the lateral meniscus part is pivotal with its point M₁ on a radius R₃ about the point M₁ of the medial side.

[0010] In the following the invention will be explained with reference to exemplary embodiments. Shown are:

[0011]FIG. 1 schematically a plan view of a tibia platform of a right knee with a firmly anchored plastic part on the medial side and a movable meniscus part of plastic on the lateral side;

[0012]FIG. 2 schematically, a section of FIG. 1 in a transversal plane in which the condyles of the knee joint are also indicated;

[0013]FIG. 3 schematically without plastic body, a plan view of the tibia platform of FIG. 1 with depressions and guiding bulges which are symmetrical with respect to the sagittal plane;

[0014]FIG. 4 schematically, analogously to FIG. 3 a tibia platform in asymmetrical design for a right knee;

[0015]FIG. 5 schematically, a section through a tibia platform as in FIG. 4 with plastic bodies;

[0016]FIG. 6 schematically, a plan view of a symmetrical tibia platform which is equipped with plastic bodies for a right knee;

[0017] and

[0018]FIG. 7 schematically, a section of FIG. 6.

[0019] The figures show a knee prosthesis comprising a medial condyle 1 and a lateral condyle 5, the running surfaces 2 of which and the counter-surfaces A, B of which that lie on a tibia platform 3 are sections of spherical surfaces with radii R₁, R₂, with their centers M₁′, M₂′ forming in their vertical projection onto the counter-surface A, B the points M₁, M₂. The lateral counter-surface B belongs to a lateral meniscus part 7 which, guided on a plane 13 of the tibia platform, is pivotal with the point M₂ on a circular arc with radius R₃ about the point M₁, with the radius R₃ corresponding to the distance a of the centers M₁′, M₂′.

[0020] In the following identical reference symbols will be used for identical functions.

[0021] In the example of FIGS. 1, 2 and 3 the tibia platform 3 is made symmetrical with respect to its sagittal midplane 14, has towards the distal a spigot 20 with ribs 18 and a central bore 16 and is provided on its upper side medially and laterally in each case with a planar 13 depression 19. Towards the middle the depression is in each case closed off by a circular bulge 10, 10′ with bounding radii R₄ and R₅. Posteriorly a recess 21 for the rear cruciate ligament is present. On the lower side a coating 17 for the better anchoring in the bone or in bone cement is provided. This coating can for example be metal grids.

[0022] In FIG. 2 two condyles 1, 5 of the femur side are indicated with phantom lines. The condyles 1, 5 and their counter-surfaces A, B on the tibia platform 3 are sections of spherical surfaces with radii R₁, R₂ and centers M₁′, M₂′. The condyles rotate during the flexion about a straight connection line of the centers M₁′, M₂′, which have a distance “a” with respect to one another. In the medial depression 19 a plastic body 12 is fixed which completely fills out the depression 19. In the lateral depression 19 an artificial meniscus part 7 of plastic is inserted which can slide on the plane 13 and which is guided by a groove 11 at the lateral bulge 10. With a vertical projection of the centers M₁′ and M₂′ the points M₁, M₂ arise on the counter-surfaces and the points M₁″ and M₂″ at the tibia platform 3 on the planes 3. The running surface 2 of the medial condyle 1 and the running surface 6 of the lateral condyle 5 project laterally somewhat. The meniscus part 7 is pivotal about the M₁ and about a vertical straight line M₁′, M₂.

[0023] In FIG. 1 the tibia platform 3 is illustrated in an extension position of the (non-illustrated) condyles in which the points M₁ and M₂ lie in a transversal plane 9 of the tibia platform 3. The condyles 1, 5 lie in each case on the counter-surfaces A, B. From this middle position the condyles can continue to rotate into a hyperextension position. At the same time ligaments at the tibia produce a torque which rotates the tibia platform 3 relative to the stationary points M₁ and M₂ by an angle α₁ in the direction towards the posterior about the point M₁. This displaced position is illustrated with phantom lines through a tibia platform 3′ and its pivoted transversal plane 9′. At complete flexion of the condyles 1, 5 a torque acts in the opposite direction at the tibia and produces a rotational movement of the tibia platform 3 by an angle α₂ about the point of rotation M₁. A tibia platform 3″ which is correspondingly pivoted towards the anterior with its pivoted transversal plane 9″ is shown in phantom lines. The medial plastic body 12 and the lateral meniscus part have flattenings 15 at their upper side which prevent unnecessarily high spherical sections from arising.

[0024] In FIG. 3 it is illustrated which movements the point M₂ of the meniscus part should make relative to the tibia platform 3 in order to fulfill the above described function. The radius R₅ for the bulge 10 amounts to between 25 and 50 mm, for example 33 mm. The sum of the angles α₁+α₂ lies between 12° and 18° , for example at 15°.

[0025] The example of FIGS. 4 and 5 shows an asymmetrical solution in which the medial side has a depression 19 for a plastic body 12, whereas the lateral side has a through-going planar guiding surface 13 from which a bulge 10 for the groove 11 of the meniscus part 7 protrudes. The kinematics of the pivotal movements between the tibia platform 3 and the meniscus part 7 is the same as in the example of FIGS. 1, 2 and 3.

[0026] A further constructional design is shown in the example of FIGS. 6 and 7; instead of circular guiding bulges have symmetrical medial and lateral depressions 19 in the form of a circular-arc-shaped groove 22 with lateral circular limitings through radii R₄ and R₅ in which a medial plastic body 12 is firmly anchored, whereas a lateral meniscus part 7 with its point M₂ is pivotal along the circular limitings around the point M₁ on a radius R₃ relative to the tibia platform. In FIG. 6 a flexion position is assumed in which the lateral meniscus part 7 is held in place unchanged by its condyle during the flexion, whereas the tibia platform 3 with its transversal plane 9 is pivoted from an initial position by an angle α₂ into a transversal plane 9″ towards the anterior. Abutments 23 limit the pivotal movement of the tibia platform 3 relative to the lateral meniscus part 7, which is shorter than the depression 19 in the direction of rotation.

[0027] Asymmetrical arrangements in which the medial depression 19 no longer represents a mirrored form of the lateral depression 19 can likewise be present in order to use the tibia platform at the right and at the left. 

1. Knee prosthesis comprising a medial condyle (1), the running surface (2) of which and the counter-surface A of which that lies on a tibia platform (3) are sections of spherical surfaces with a radius R₁, the center M₁′ of which forms in its vertical projection on the counter-surface A an axis (4) with a point M₁ about which a lateral condyle (5) is pivotal, characterized in that the lateral condyle (5) with its running surface (6) and its counter-surface B are likewise sections of spherical surfaces with a radius R₂ with center M₂′, the vertical projection of which onto the counter-surface B corresponds to a point M₂; and in that the counter-surface B belongs to an artificial meniscus part (7) which can be displaced on a plane of the tibia platform and which, guided on a circular arc, is pivotal with the point M₂ about the point M₁ at a distance R₃ which corresponds to the distance a of the centers M₁′, M₂′.
 2. Knee prosthesis in accordance with claim 1 , characterized in that when the meniscus part is held firmly the tibia platform (3) is pivotal by an angle α₁≧0 towards the posterior and by an angle α₂>α₁ towards the anterior about the axis (4) M₁, M₁′ from a middle position in which the points M₁, M₁′; M₂, M₂′ lie in a transversal plane (9) of the tibia platform (3).
 3. Knee prosthesis in accordance with claim 2 , characterized in that the angle α₂ lies between 5° and 20°.
 4. Knee prosthesis in accordance with any one of the claims 1 to 3 , characterized in that the guiding of the meniscus part (7) takes place through a circular-arc-shaped bulge (10) of the tibia platform (3) on the inner side of the lateral half of the tibia platform (3) which engages into a groove (11) of the meniscus part (7).
 5. Knee prosthesis in accordance with any one of the claims 1 to 4 , characterized in that the counter-surface A is formed of a plastic body (12) which is secured on the tibia platform (3); and in that the meniscus part (7) consists of plastic.
 6. Knee prosthesis in accordance with any one of the claims 1 to 5 , characterized that the tibia platform (3) is made symmetrical with respect to the its sagittal midplane (14) in such a manner that each side is selectively suitable for the reception of a firmly anchorable plastic body (12) or of a movable meniscus part (7) in order to produce right and left tibia joint halves with one tibia platform (3).
 7. Knee prosthesis in accordance with any one of the claims 1 to 6 , characterized in that a radius R₁, R₂ of one condyle (1, 5) is smaller than the radius R₂, R₁ of the other condyle (5, 1) by a specific amount; and in that the counter-surface A, B belonging to this smaller condyle projects further upwardly by this specific amount.
 8. Knee prosthesis in accordance with claim 4 , characterized in that bulge (10) with its outer guiding surface corresponds to a radius R₅ to the point M₁; and in that the radius R₅ corresponds to an amount between 25 mm and 50 mm.
 9. Knee prosthesis in accordance with any one of the claims 2 to 8 , characterized in that the sum of the angles α₁ and α₂ lies between 12° and 18°.
 10. Knee prosthesis in accordance with any one of the claims 1 to 3 , characterized in that the guiding of the meniscus part (7) takes place through a circular arc-shaped groove (22) with an outer radius R₅ and an inner radius R₄ on the lateral side of the tibia platform (3).
 11. Knee prosthesis in accordance with claim 10 , characterized in that the tibia platform is made symmetrical with respect to its midplane (14); and in that an anchorable plastic body (12) or a movable meniscus part (7) of plastic is selectively available for each circular arc-shaped groove (22). 